A growing pattern of automated E/M reductions is appearing across multiple states, and most practices won’t see the losses until the month-end numbers don’t add up. Your E/M payments may already be shifting.
Starting October 1, 2025, Cigna Healthcare’s R49 downcoding policy is set to catch many practices off guard. These denials are not clerical mistakes; they’re part of a systemic tightening on higher-level E/M codes. Cigna Healthcare will not provide healthcare providers any notice; it happens automatically.
Sep 194 min read
In fact, one healthcare provider we worked with achieved 132% of monthly collection goals.
⚠️ Is Your Practice at Risk?
Book a complimentary 15-minute contract risk call this week.
I'll help you identify:
✓ Hidden revenue leaks in your payer contracts
✓ Downcoding exposure you might not see
✓ Early warning signs of contract breakdown
